Let Us Know
The Let Us Know program is a partnership between Keystone First and the provider community to collaborate in the engagement and management of our chronically ill members. We have support teams and tools available to assist in the identification, outreach, and education of these members, as well as clinical resources for providers in their care management.
There are three ways to let us know about chronically ill members.
1. Contact our Rapid Response and Outreach Team: They are here to support you!
The Rapid Response and Outreach Team (RROT) address the urgent needs of our members and supports providers and their staff. The RROT consists of registered nurses, social workers, and care connectors who are trained to assist members in investigating and overcoming the barriers to achieving their health care goals.
Call 1-800-573-4100 from 8:00 a.m. until 6:30 p.m. or fax a member intervention request form (PDF) to 1-800-647-5627.
2. Use the NaviNet care gap worksheet
A pop-up alert occurs when checking member eligibility in NaviNet. These alerts indicate the member is at risk due to missing or overdue preventive services, or under-utilization or absence of disease-specific controller medications. Clicking on the alert generates a member-specific care gap worksheet (PDF).
Use the care gap worksheet to request RROT outreach for the member on NaviNet.
3. Refer a patient to the complex case management program
Complex case Management is a voluntary program focused on prevention, education, lifestyle choices and adherence to treatment plan and is designed to support your plan of care for patients with chronic diseases, such as asthma, diabetes, or coronary artery disease. Members receive educational materials and, if identified as high risk, will be assigned to a care manager for one-on-one education and follow up. For more information, or to refer a patient to the complex case management program, call 1-800-573-4100.